<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('代理名称')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_name" class="form-control" name="row[user_name]" type="text" value="{$row.user_name|htmlentities}">
        </div>
    </div>
    
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_card_count')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_card_count" class="form-control" name="row[user_card_count]" type="number" value="{$row.user_card_count|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_active_card_count')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_active_card_count" class="form-control" name="row[user_active_card_count]" type="number" value="{$row.user_active_card_count|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Travel_count')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-travel_count" class="form-control" name="row[travel_count]" type="number" value="{$row.travel_count|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Total_profit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-total_profit" class="form-control" name="row[total_profit]" type="number" value="{$row.total_profit|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Agent_profit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-agent_profit" class="form-control" name="row[agent_profit]" type="number" value="{$row.agent_profit|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Travel_profit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-travel_profit" class="form-control" name="row[travel_profit]" type="number" value="{$row.travel_profit|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_money" class="form-control" name="row[user_money]" type="number" value="{$row.user_money|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('With_money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-with_money" class="form-control" name="row[with_money]" type="number" value="{$row.with_money|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
